Hispanics still lagging in sun-safe behaviors

NEW YORK (Reuters Health) - Hispanics shouldn't assume their darker skin means they can't get skin cancer, and they should make sure to protect themselves when they're out in the sun, according to a new report.

In a survey, researchers found Hispanic adults who had lived in the U.S. for longer and had better knowledge of English were more likely to wear sunscreen, as were those with more education and those who talked to their friends and family about health.

But the same people might still not cover up with long-sleeve shirts and pants or seek out shady spots for sun protection -- putting them at risk for melanoma, a deadly skin cancer, researchers reported today in the Archives of Dermatology.

There's a "misunderstanding" among some parts of the population that they're not at risk for skin cancer, said dermatologist Dr. Elizabeth Tanzi, from the Washington Institute of Dermatologic Laser Surgery in Washington, D.C.

But that "is absolutely unequivocally untrue," she told Reuters Health.

"All skin types, regardless of how much color you have to your skin, can get skin cancer," said Tanzi, who was not involved in the new study.

According to the National Cancer Institute, more than 70,000 Americans will get melanoma in 2011. Nearly 8,800 will die of the disease, which is several times more common in whites than in blacks, Asians, or Hispanics.

For the new work, researchers led by Valentina Andreeva at the University of Southern California in Los Angeles analyzed data from a phone survey sponsored by the National Cancer Institute.

That survey, conducted in 2005, asked close to 500 Hispanic participants how often they wore sunscreen or practiced other "sun-safe" behaviors and included questions about their physical health, education, and connections with friends and family.

The surveys also assessed how comfortable participants were with the English language and asked them how long they had been living in the United States.

Out of 496 respondents, 15 percent said they always used sunscreen, compared to about 39 percent who never did. More participants -- about 26 percent -- said they always stayed in the shade outside on sunny days, and 13 percent always wore long-sleeve shirts, said Andreeva, now at University of Paris XIII in France.

Hispanics who had been in the U.S. for longer or had a greater grasp of English were more likely to use sunscreen, but less likely to wear long-sleeve clothes for sun protection compared to newer immigrants or those who mostly spoke Spanish.

People with more education and those who talked to friends about health said they used sunscreen more often than others. But they also didn't wear more sun-protective clothing and weren't any more likely to seek out shade on sunny days.

The researchers noted that some Hispanics may be particularly at risk of skin cancer, including men who have outdoor jobs with lots of sun exposure.

"Both physicians and Hispanic patients feel that these kinds of health behaviors don't really apply to them because their (cancer) rates are so much lower," Andreeva told Reuters Health.

While Hispanics have a lower skin cancer risk than whites, she said, when they do get cancer it's typically caught later on, at a more dangerous stage. That, combined with the growing Hispanic population in the U.S., makes skin protection for this group especially important, she added.

Overall, though, the researchers note that no ethnic group currently meets the sun-protection guidelines.

Tanzi said doctors need to make sure to educate their patients about the risks of sun exposure, even if they assume that everybody knows those risks by now. And researchers need to figure out how to tap into Hispanic social networks to get that message out to people who might not regularly visit a doctor.

Dr. Arturo Dominguez, a dermatologist at University of Texas Southwestern Medical Center in Dallas who wrote a commentary on the study, said it's important to remember that Hispanics vary widely in their culture, income, and the color of their skin.

While Hispanics who have been in the U.S. for a while might benefit from print and TV campaigns on sun safety, for newer immigrants "those strategies to increase awareness of skin cancer and sun-safe behavior are going to have to focus on those techniques that are used within their own home countries," such as training lay health workers to share information within communities, he told Reuters Health.

A research letter in the same journal found that blacks may also underestimate their risk of skin cancer and not wear sunscreen, even those who have had severe sunburns. Dr. Pamela Summers of Case Western Reserve University in Cleveland and colleagues found that among all races, women and those with more education and a higher income were more likely to report using sunscreen.

"Everyone needs to practice sun safety," said Tanzi. "No one is immune."